injuries to the shoulder and elbow in the young athlete
TRANSCRIPT
Injuries to the Shoulder and Elbow in the Young AthleteInjuries to the Shoulder and Elbow in the Young Athlete
John F. Meyers, M.D.John F. Meyers, M.D.
Shoulder GirdleShoulder Girdle
Ligaments 2-5X Stronger that Epiphyses
Ligaments 2-5X Stronger that Epiphyses
Glenohumeral JointGlenohumeral Joint
Little League ShoulderLittle League Shoulder
Perry-Anterior RestraintsPerry-Anterior Restraints
• Retroversion
• Labrum
• AIGHL
• Subscapularis
• Retroversion
• Labrum
• AIGHL
• Subscapularis
Surgical Treatment86% Returned to Sports
Surgical Treatment86% Returned to Sports
Surgical TreatmentSurgical Treatment
• Remove loose bodies
• Excise Capitellar Lesions
• Curette Base
• Remove loose bodies
• Excise Capitellar Lesions
• Curette Base
Posterior Elbow ProblemsPosterior Elbow Problems
• Triceps Tendonitis
• Traction Apophysitis
• Nonunion Olecranon Epiphysis
• Triceps Tendonitis
• Traction Apophysitis
• Nonunion Olecranon Epiphysis
Long Term EffectsJobe
Long Term EffectsJobe
• Olecranon Spurs
• Loose Bodies
• Stretching of the UCL
• Olecranon Spurs
• Loose Bodies
• Stretching of the UCL
PreventionPrevention
PappasPappas
• Curve – Medial
• Fast Ball – Lateral
• Curve – Medial
• Fast Ball – Lateral
AlbrightAlbright
• Sidearm – 75% Elbow Pain
• Overhead – 27% Elbow Pain
• Sidearm – 75% Elbow Pain
• Overhead – 27% Elbow Pain
TorgTorg
• Limit the number of innings pitched
• Limit the number of innings pitched
GymnasticsGymnastics
Fractures and DislocationsFractures and Dislocations
Valgus InjuriesValgus Injuries
Singer & Roy4 of 5 ReturnedSinger & Roy
4 of 5 Returned
Jackson0 of 12 Returned
Jackson0 of 12 Returned
Thank YouThank You
Orthopaedic Research of Virginia
Orthopaedic Research of Virginia
Elbow Injuries in AthletesElbow Injuries in Athletes
John F. Meyers, M.D.John F. Meyers, M.D.
AnatomyAnatomy
TraumaTrauma
DislocationDislocation
MonteggiaMonteggia
Supracondylar FractureSupracondylar Fracture
Olecranon FractureOlecranon Fracture
Radial Head FractureRadial Head Fracture
Throwing InjuriesThrowing Injuries
Ligament InjuriesLigament Injuries
Osteochondritis DissecansOsteochondritis Dissecans
Little League ElbowLittle League Elbow
Nerve InjuriesNerve Injuries
Overuse InjuriesOveruse Injuries
Tennis ElbowTennis Elbow
Elbow ArthroscopyElbow Arthroscopy
NirschlNirschl
• Tendonitis
• Muscle Weakness
• Upward Migration of Head
• Tendonitis
• Muscle Weakness
• Upward Migration of Head
Micheli GlousmanMicheli Glousman
• Subtle Instability
• Traction Injury to Rotator Cuff
• Subtle Instability
• Traction Injury to Rotator Cuff
Elbow InjuriesElbow Injuries
Baseball GymnasticsBaseball Gymnastics
Little League StudiesLittle League Studies
• 20% Elbow Pain
• 33% X-Ray Changes
• 20% Elbow Pain
• 33% X-Ray Changes
Adolescent PitchersAdolescent Pitchers
• 58% Elbow Pain
• 56% X-Ray Changes
• 4% Loose Bodies
• 58% Elbow Pain
• 56% X-Ray Changes
• 4% Loose Bodies
Ligament InjuriesLigament Injuries
Nerve InjuriesNerve Injuries
Panner’s DiseasePanner’s Disease
• < age 11
• Entire Capitellum
• Self Limited
• < age 11
• Entire Capitellum
• Self Limited
O.C.D.O.C.D.
• > age 11
• Localized
• Loose bodies
• > age 11
• Localized
• Loose bodies
Simonet & CofieldSimonet & Cofield
82% Recurrence in Athletes82% Recurrence in Athletes
Anterior SubluxationAnterior Subluxation
Dead Arm SyndromeDead Arm Syndrome
DiagnosisDiagnosis
• Apprehension
• Arthroscopy
• Apprehension
• Arthroscopy
McGlynn & CaspariMcGlynn & Caspari
• Hill Sachs Lesion
• Labral Tearing
• Incompetent AIGHL
• Hill Sachs Lesion
• Labral Tearing
• Incompetent AIGHL
Arthroscopic Treatment of Anterior Shoulder InstabilityArthroscopic Treatment of
Anterior Shoulder Instability
• Bankart Lesion – Repair
• Incompetent – Graft AIGHL
• Bankart Lesion – Repair
• Incompetent – Graft AIGHL
Posterior Dislocation 4%Posterior Dislocation 4%
Posterior SubluxationAverage Age at Onset
16
Posterior SubluxationAverage Age at Onset
16
Posterior SubluxationPosterior Subluxation
• Voluntary
• Unintentional
• Habitual
• Voluntary
• Unintentional
• Habitual
Function Instability Pappas
Function Instability Pappas